title: Does a preoperative bowel preparation reduce bowel morbidity and length of stay after scoliosis surgery? A randomized prospective study.
abstract: BACKGROUND
  Constipation is a common problem after surgery for adolescent idiopathic scoliosis (AIS), with bowel morbidity being reported as high as 78%. The purpose of this study was to determine if a preoperative bowel preparation reduces the incidence of bowel morbidity after surgery for AIS.
  
  
  METHODS
  This is an IRB-approved randomized, prospective study of 60 consecutive patients who underwent surgery for AIS. After consent to participate was signed by the patients' family, patients were randomized to either a preoperative bowel preparation (group A) or no bowel preparation (group B). Bowel morbidity data were then collected and compared postoperatively.
  
  
  RESULTS
  Complete data were available for 27 patients in group A and 28 in group B. Postoperatively, we found that group A had less weight gain (P<0.09), fewer postoperative bowel medications (P<0.023), and a shorter time to first bowel movement (P<0.03) when compared with group B. Two patients in group B had persistent constipation after discharge, one requiring readmission to the hospital. One patient in group B developed a postoperative wound infection. There were no adverse events in group A postoperatively.
  
  
  CONCLUSIONS
  This study did show a modest reduction in some aspects of bowel morbidity when patients had a preoperative bowel preparation before scoliosis surgery. However, these differences did not reach statistical significance. Therefore, we do not recommend routine preoperative bowel preparations for AIS patients.
  
  
  METHODS
  Level II.
authors.affiliation: Department of Orthopaedics, University of Utah School of Medicine, Primary Children's Medical Center, Salt Lake City, UT.
authors.forename: John T
authors.initials: JT
authors.lastname: Smith
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D002400:Cathartics / Q000627:therapeutic use*; D003248:Constipation / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects / Q000502:physiology; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D012600:Scoliosis / Q000601:surgery*
chemical_list: D002400:Cathartics